National Capital Consortium Pediatrics Residency
Policies and Procedures for Leave and Call
This document describes policies and procedures for leave, call, maternity and paternity
leave, international travel, and what to do when you are too ill to report for duty.
Leave
Leave for the year should ideally be planned at the beginning of the academic year. PL1’s may take 2 weeks of leave. Leave is not allowed during inpatient rotations. Some
times of the year are more desirable than other for taking leave, but there are a certain
number of residents needed to cover inpatient services, so only a fixed number of
residents can take leave at any one given time. Leave requests are granted on a firstcome-first-serve basis.
PL-2’s and PL-3’s may take 3 weeks of leave per year. Again, leave is not allowed
during inpatient rotations and during adolescent medicine. Plan your leave early and
have it approved IN ADVANCE by the chief resident, the program director, and the
supervisor of the rotation from which you will miss time.
There is a distinction between ‘military leave’ and ‘program leave.’ Program leave is also
known as vacation in the civilian world. Military personnel are given 30 days of paid
military leave each year, a benefit not able to be exercised during GME. This leave will
accrue and can be used after graduation or during operational assignments during training
such as GMO tours.
In certain circumstances, a resident can take military leave which will not count as
program leave. One such example is emergency leave; a resident can call the Program
Director at any time 24/7/365 to request emergency leave. See ‘Personal Emergencies’
below for more details.
A more common example is fortuitous periods of time the resident is on liberty and
wishes to take leave. This primarily applies to Army personnel who have liberty travel
restrictions and must take leave if travelling outside a certain radius. Taking military
leave which does not count against program leave can only occur if the following
conditions are met:


Leave will be taken during a time when the resident otherwise would be on liberty
o Weekend for normal work schedules
o Other days of liberty for those on alternate work schedules or shift work
The resident would have been on liberty ONLY because the resident was not scheduled
for duty even though the resident did not request those days to be off-duty. This occurs
prior to the Chief Resident, the off-site rotation supervisor, or emergency department
scheduler makes shift schedules.
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National Capital Consortium Pediatrics Residency
Policies and Procedures for Leave and Call
o
Mutually agreed-upon switches with other residents in order to have liberty on a
certain date, done after schedule requests are made and schedules assigned, if the
resident made a request and was denied, satisfy this requirement.
As the chief resident is preparing to make the call schedule, he/she will ask if there are
leave requests. Please read your email so you can respond in a timely fashion.
When you want to take leave:

Leave must be submitted in three ways
o Using the amion on-call schedule request feature
o Obtaining pre-approval from the chief resident and rotation supervisor
which is then sent to the Program Director or the Associate Program
Director. This can be done with an email copied to the chief resident,
rotation supervisor, and the PD/APD.
o Using the service-specific leave routing system (see below)

Ensure that there is no continuity clinic schedule or booked patients in the
system for you during your leave. Contact the chief resident and Dee Dornell
(scheduling at WRNMMC-Bethesda).

Ensure that all AHLTA notes and tel-cons are complete.

Ensure that all military training is up-to-date (particularly important for the
Army)

The next steps are service-specific and are on the next 3 pages
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National Capital Consortium Pediatrics Residency
Policies and Procedures for Leave and Call
ARMY (don’t forget to complete the bolded program steps above)
Alpha & Student Company Checklist:
1. LES
* Print out most recent LES from MyPay via your AKO account.
2a. TRIPS if driving:
* Travel Risk Planning System (TRIPS): https://safety.army.mil/
* Click on TRIPS icon to complete required questionnaire.
* Either email to supervisor using their AKO email (Student Co: CPT Wrighten;
Alpha Co: SGT Jury) OR print out certificate and add to leave package.
2b: Itinerary if flying: Print out from your airline or travel agency website.
3. FMR
* Got to AKO and click on “medical readiness” (should be GREEN).
* On the TOP RIGHT corner, select “Print” to print the entire FMR document.
* If you are going to turn amber during the time that you are on leave, you must
complete that requirement prior to turning in leave (double check w/SGT Jury if
unsure).
4. DA 31: Official Leave Form
* Located both at the end of the TRIPS questionnaire AND on AKO (press Forms
tab and search for DA 31). You can fill out electronically (preferred) or by hand.
* Dr. Gorman is your supervisor, who also needs to sign this form.
* Ms. Theresa Kiefer, Program Coordinator, can help you fill out, if you are
unsure.
5. A vehicle (POV) inspection if driving:
* Can obtain in Peds office on 2nd floor, Peds S:// drive, or the following website:
http://www.belvoir.army.mil/safety/doc/povinspection.pdf
* Can be done by one of your peers, if you are in Student Company. Can be done
by one of the NCOs in the Peds Office, if you are in Alpha Company. Bottom
line— It does not have to be done by a mechanic.
** Once you have this ENTIRE packet completed and signed by the appropriate
people. Hand in to the NCOIC for Peds (regardless of Student or Alpha Company).
They will take care of routing it to the appropriate office.
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National Capital Consortium Pediatrics Residency
Policies and Procedures for Leave and Call
NAVY (don’t forget to complete the bolded/italicized program steps above)
Navy residents use the Navy e-leave system through the NSIPS website E-Leave Link:
https://nsips.nmci.navy.mil/ This link is also available on the nccpeds.com website
under the Military -> Navy Page menu item. The request is electronically routed through
contingency and the department training officer before it can be approved by the PD or
Navy APD.
AIR FORCE (don’t forget to complete the bolded/italicized program steps above)
TO access leave web:
-During inprocessing you probably turned in a request for leave web access
to the CSS office at Malcolm Grow. If not, they will need this to get you an account.
-Go to my.af.mil from a CAC login computer to access Leave web.
-A link for leave web is along the left hand side of the home page.
-If you do not have a password, I would contact the leave web administrator at Andrews,
phone number is 240-857-8225 to get this set up
-When applying for leave, simply submit a request online up to 30 days prior to leave
date and they approve them fairly quickly
-Your supervisors name and info is as follows:
 AO Rank: LT COL
 AO Name: Natalie A Giscombe
 AO Phone: (240) 857-8280
 AO EMail: Selea.hayes@afncr.af.mil
- You will need to enter this in so she can approve the leave
(Ph#: 240-857-8703)
- Upon return from leave, go back to same website and submit return from leave status
If you forget this step, you will get an email from Laurie Creel telling you to do so asap
so they dont think you are AWOL of something.
** Potential NEW approving official: COL Sandra Tynes. Email LtCOL Giscombe
and/or Ms. Creel to double-check who your Approving Official (AO) is prior to
filing your leave**
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National Capital Consortium Pediatrics Residency
Policies and Procedures for Leave and Call
Notes on international travel
International travel (setting foot in a foreign country at any time in your itinerary)
requires a country clearance form. Please consult your local service-specific leave office
for international travel requirements.
Note on Illnesses
For those new to the military, it is a requirement that medical care for active duty
personnel be provided by military physicians in a military treatment facility. If you are
just entering the service and have ongoing medical problems, you should make
arrangements to have that care transferred to a physician at WRNMMC.
Practicing effective infection control measures such as hand washing can decrease but not
eliminate your risk of illnesses. It is not uncommon, though, for residents who are
constantly treating ill children to become ill themselves. If you are ill, you should discuss
your symptoms with your supervisory resident and your attending. With certain illnesses
you may do patients more harm if you continue to work and expose them to your
pathogens.
If you feel you are too ill to work, you should:
a) notify your supervisory resident and your attending as soon as possible and
b) make arrangements to go to military sick call so you can be examined and
given any treatment you may need to help you recover.
Personal Emergencies
All of us have personal emergencies that arise from time to time. When a personal
emergency arises, the patients for whom you are responsible don’t just go away. It is
imperative that you notify your attending and supervisory resident about your emergency
as soon as possible so that you can be provided the support you need, your patients can be
covered, and you will be legally protected. It is not enough to call and leave a message.
YOU MUST MAKE PERSONAL CONTACT WITH YOUR IMMEDIATE
SUPERVISOR.
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National Capital Consortium Pediatrics Residency
Policies and Procedures for Leave and Call
Call
Working hours during residency are long, particularly during inpatient rotations. The
rotation and call schedules for this year have been developed with several goals in mind:
 Residents and interns will not work more than 80 hours per week averaged over 4
weeks
 You must have an average of one 24-hour period each 7 days without hospital
responsibilities.
 Residents will not work more than 30 hours per shift and there will be 10 hours of
rest between shifts.
 Interns will not work for more than 16 hours per shift and there will be 10 hours
of rest between shift
To provide maximal continuity of care, the following policies will be in effect:


Residents will have signed out their patients to the designated relief or cross
coverage resident before leaving the hospital.
Residents on electives or outpatient rotations who have been on call for an
inpatient rotation the previous night may complete inpatient sign-out, attend
educational activities, or see their continuity patient the morning after call. The
resident is required to leave the hospital by noon on their post-call day.
Liberty/Pass
Special liberty or pass is granted very rarely and only for special circumstances. It is not
meant to take the place of leave. If you are granted pass or liberty by the program
director or department head, you must also inform your rotation supervisor. You must
also have a liberty chit or pass form in your possession while you are gone.
For the Army, you can only travel within a 180-mile radius of the hospital without a pass
form. If you are traveling greater than 180 miles, you must have a signed pass form in
your possession.
For the Navy, there is no set regulation. You must be able to be at your assigned duty
station at the prescribed time.
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National Capital Consortium Pediatrics Residency
Policies and Procedures for Leave and Call
Maternity/Parental Leave Policy
To combine residency training with parenthood is a major challenge to the trainee, the
trainee’s spouse, other trainees in the program and staff. To aid trainees who become
pregnant, adopt a child, or wish to take paternity leave during GME programs, the
Consortium provides the following policies based on existing maternity leave
instructions, ACGME requirements, and recommendations of the American Medical
Association.
1. Policies
a. The Consortium and its members will support the pregnant trainee and
GME training program.
b. Leave taken prior to delivery, unless medically ordered will count against
regular leave time allowed by the program.
c. For female trainees, forty two (84) days of maternity leave will be granted
following pregnancy and delivery. Maternity leave does not need to be
taken all at once or consecutively, but must be used within 1 year of the
child’s birth. The program requests that residents plan maternity leave
taken non-consecutively in consultation with the Chief Resident to
minimize disruption to the training plan of the resident as well as the
resident’s peers.
d. The American Board of Pediatrics has determined that residents must
complete 33 months of a 36-month pediatric residency in order to sit for
the board certifying examination. Leave and/or convalescent leave in
excess of 90 days over the course of the three-year residency will
necessitate an extension of the residency-training program.
e. Interns must complete 48 weeks of training during the PL-1 year to
receive credit for internship. Interns are allowed 2 weeks of regular leave.
Trainees utilizing this 2 weeks plus any convalescent leave would have
their internship extended if they did not meet the minimum requirements
of their service for training.
f. Residents are routinely allowed 3 weeks of regular leave during the PL-2
and PL-3 year. This leave is generally taken in blocks of 1 week or less
and depends on staffing needs of the program. Blocks of leave larger than
1 week are granted at the discretion of the program director.
g. No convalescent leave can be granted for an adopting parent. Adoption is
not a medical condition that requires convalescence.
h. Parental leave for natural fathers and residents adopting a child will be
granted up to 2 weeks and will be counted as the regular leave allowed
during those years. Trainees must give notice of intention to take parental
leave as soon as possible and at least 30 days before taking the leave to
minimize disruptions in call and rotation schedules for other trainees.
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National Capital Consortium Pediatrics Residency
Policies and Procedures for Leave and Call
i. Academic and call schedules for the pregnant resident will be modified in
accordance with the recommendations of the resident’s OB/GYN
physician. These decisions will be medically based and administratively
implemented by the respective service chiefs and the Program Director.
j. Modifications in the pregnant resident’s academic and call schedules (such
as “frontloading” of the call schedule early in the pregnancy) should
reflect the abilities of the resident and her stamina with consideration
given to her overall health to insure the best outcome for the pregnancy.
2. Responsibilities
a. The Trainee will:
 Have an obstetric physician confirm a suspected pregnancy as
early as possible, issue a pregnancy profile, and initiate prenatal
care as early in the pregnancy as possible;
 Notify the Program Director about the pregnancy as soon as the
pregnancy is confirmed and receive counseling about the training
requirements;
 Immediately notify the Program Director of any complications
that may affect duty performance;
 Follow the conditions of the medical pregnancy profile;
 Follow the Program Director’s guidance as it relates to training,
schedules, and time requirements to fulfill all specialty board
requirements;
 Continue to perform military duties until delivery time unless
excused from formal duties by the obstetric physician, in which
case she may be hospitalized, placed on sick leave, given limited
duty, or assigned to quarters;
 Take up to a maximum of 84 days of maternity leave following
delivery unless otherwise requested by her obstetric physician.
b. The Department of OB/GYN will:
 Confirm the pregnancy by pregnancy test, ultrasound, or pelvic exam
by a licensed provider;
 Provide a pregnancy profile and notify the trainee’s Program Director
indicating any and all limitations placed on the trainee;
 Ensure that pregnant trainees receive prenatal, perinatal, and
postpartum care;
 Advise the Program Director of any needed changes in the trainee’s
profile or approved duties;
 Recommend convalescent leave as per service-specific instructions.
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National Capital Consortium Pediatrics Residency
Policies and Procedures for Leave and Call
c. The Program Director will:
 Adjust the trainee’s duty roster on the pregnancy profile;
 Notify other housestaff of all rotation changes as soon as possible to
minimize disruptive changes on the other GME trainees;
 Counsel that trainee regarding the requirements and make appropriate
decisions and adjustments because of the trainee’s absences;
 Ensure that pregnancy does not provide the basis for adverse action
against a trainee;
 Closely monitor the pregnant trainee’s work week, call schedule, and
continuous hours worked without rest and ensure that this schedule is
consistent with that recommended by the trainee’s obstetrician;
 Determine if the trainee can adequately meet specific requirements for
Board Certification;
 Notify the chief of the specific departments/services of any changes or
conditions that affect the trainee’s performance in the program;
 Notify the appropriate GME office of any adjustments in length of
training required by the trainee;
 Approve 42 days of convalescent leave following delivery;
 Initiate a request for extension of training if a resident cannot comply
with service-specific or RRC guidelines due to requirements for
convalescent leave.
Page 9 of 9; updated January 2016